Individual
TRACEY E MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
1838 BLACKWATER DR, MARIETTA, GA 30066-6712
(678) 472-3695
Mailing address
1838 BLACKWATER DR, MARIETTA, GA 30066-6712
(678) 472-3695
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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